8-Tab 5.pdf

PDF 86 KB Posted

Attached to
Voter Registration Certificates
Solicitation number
ITB 261001
Issued by
Hunt County, Texas

About this file

This document is a Certification Regarding Lobbying form for Procurement Number ITB 261001, issued by Lubbock County's Director of Purchasing for Voter Registration Certificates. The form requires proposers to certify that they have not and will not use Federal appropriated funds to influence or attempt to influence government officials in connection with Federal contracts, grants, loans, or cooperative agreements.

The certification requires proposers to disclose any non-Federal funds used for lobbying purposes by completing Standard Form LLL if applicable. Proposers must also include this certification language in all subaward documents at all tiers. Failure to file the required certification can result in civil penalties ranging from $10,000 to $100,000 for each violation. The form must be completed, signed, dated, and returned to the Lubbock County Director of Purchasing, with spaces provided for organization details, address, and authorized signatory information.

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Text version

CERTIFICATION REGARDING LOBBYING

(31 U.S.C.A. § 1352)

This Certification must be completed, signed, dated and returned to the Lubbock County Director of Purchasing

Procurement Number and Description: ITB 261001, VOTER REGISTRATION CERTIFICATES

Proposer CERTIFIES, to the best of its knowledge and belief, that:

1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the proposer, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the proposer shall complete and submit Standard Form LLL, "Disclosure Form to Report Lobbying", in accordance with its instructions.

3. Proposer shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Name of Organization/Corporation: _______________________________________________________

Address: _____________________________________________________________________________

City: ____________________________ State: ___________________________ Zip Code: __________

Signature of Authorized Date

Signatory for Proposer: ______________________________________ Signed: ____________________

Title of Authorized Signatory of Proposer: __________________________________

File details come from the government source that posted it. Updated .